Objective To explore the association between growth patterns and blood pressure in children and adolescents with different nutritional status.
Methods A total of 38 839 children and adolescents aged 6 to 8 years old were included in this study by stratified cluster sampling. The American Academy of Pediatrics 2017 Guideline was used to evaluate the blood pressure, the US 2000 CDC standard was used to determine different growth patterns, and the WHO Child and Adolescent Growth and Development Standard issued in 2007 was used to evaluate nutritional status. Variance analyses were used to compare the levels of systolic and diastolic blood pressure and growth patterns by nutritional status, and χ 2 test was used to compare the difference of prevalence. Multivariate Logistic regression model was used to analyze the association between growth patterns and blood pressure.
Results The proportion of normal growth, catch-up growth and catch-down growth was 33.2%, 41.6% and 25.2%, respectively. Under different growth patterns, systolic blood pressure (105.17±12.33) mm Hg and diastolic blood pressure (66.55±8.75) mm Hg of catch-up growth were higher than those of normal growth and catch-down growth. In overweight and obesity, the prevalence of hypertension (24.9%), high systolic blood pressure (18.9%) and high diastolic blood pressure (15.0%) in catch-up growth were higher than those in normal growth and catch-down growth ( P<0.05). The risk of catch-up growth to hypertension was higher in overweight and obesity ( OR = 1.18, 95% CI = 1.06-1.31) than in normal children and adolescents ( OR = 1.15, 95% CI = 1.05-1.27).
Conclusion In catch-up growth children and adolescents, hypertension and high blood pressure are higher than normal growth and catch-down growth. Overweight and obesity than normal children and adolescents have a higher risk of hypertension.
【摘要】 目的 探讨不同营养状况下儿童青少年生长模式与血压之间的关联, 为促进中国儿童青少年正常生长发育和身心健康提供依据。 方法 采用分层整群抽样方法, 于2012年纳人6~18岁儿童青少年38 839名。采用《美国儿科学会2017指南》评价个体的血压状况, 采用美国2000年CDC标准判定不同的生长模式, 采用WHO于2007年发布的儿童青少年生长发育标准评价个体营养状况。不同营养状况和生长模式下收缩压和舒张压水平之间比较采用方差分析, 检出率之间的比较采用χ 2检验;采用多因素Logistic回归模型分析不同营养状况下生长模式与血压之间的关联。 结果 青少年正常性生长、追赶性生长和迟缓性生长占比分别为33.2%, 41.6%和25.2%。在不同生长模式下, 追赶性生长的收缩压 (105.17±12.33)mm Hg和舒张压(66.55±8.75)mm Hg均髙于正常性生长和迟缓性生长。在超重肥胖的儿童青少年中, 追赶性生长的髙血压检出率(24.9%)、髙收缩压检出率(18.9%)和髙舒张压检出率(15.0%)均髙于正常性生长(21.6%, 16.2%, 12.9%)和迟缓性生长(20.1%, 14.7%, 12.5%), 差异均有统计学意义(χ 2值分别为24.24,22.05, 11.13, P值均<0.05)。超重肥胖儿童青少年追赶性生长对发生髙血压( OR=1.18,95% CI=1.06~1.31)的危险程度大于正常体重的儿童青少年( OR=1.15,95% CI=1.05~1.27)。 结论 追赶性生长的儿童青少年血压水平较髙, 髙血压、髙收缩压和髙舒张压检出率也较髙。追赶性生长的超重肥胖儿童青少年比正常儿童青少年发生髙血压的危险性更髙。